Health Information Technology and the Role of Cognition and Human Factors

Engineering

Vimla L. Patel, PhD, DSc, FRSC

Center for Cognitive Informatics and Decision Making

School of Biomedical Informatics

The University of Texas Health Science Center at Houston

Vimla.Patel@uth.tmc.edu

Presented at the Symposium on Los retos de la era de la

información en nuestro país, Universidad Nacional Autónoma de México (UNAM), Mexico City

March1-2, 2011

Institute of Medicine

                                                                                                      

Health Information Technology

• Computer technology has revolutionized health care

• But HIT has not been without its challenges

• Human Factors: The science of understanding the properties of human capacity

• Human Factors Engineering: The application of this understanding to the design, development, and deployment of systems and services

Current Status and Challenges

• Easy but selective access to patients’ discharge summaries, consultation reports, and data such as X-rays or CT Scans

• Challenge: Integrating information in different formats (narrative text, numerical, graphical) from various clinical sources

• Challenge: Cognitive load increases with integration of knowledge from different sources

Current Status and Challenges

• Warnings are given for drug-drug interactions, overdosing of medications, and any allergies. This reduces medical hazards.

Challenge: Clinicians often ignore warnings and reminders if they are too frequent or are viewed as trivial

• Computer systems contain extensive clinical data and display them in respond to user requests

Challenge: To be able to represent and display relevant patient information in a way that can used effectively and efficiently for health care decisions (visualization)

Challenges and Solutions

Challenge: When information technology is not implemented or not well integrated into workflow, unnecessary tasks are performed and errors are generated.

Solutions: Understanding of real world health care practice.

Describe what clinicians do in their workplaces (clinical workflow). What are their daily tasks? Kinds of demands they have on their memory, clinical problem solving and decision making? How can technology help to manage these demands?

Challenges and Solutions

• Health care is moving toward team work; collaborations and communication breakdowns are very common: Development and use of computer-based collaborative software becomes critical

• The healthcare system is complex, and current methods of investigations do not provide accurate data for informatics related interventions: Complexity of health care system will require new ways of data collection and monitoring

Resource Sharing Between Human Minds and the Technology that

Supports Cognitive Work

Intellectual Partnership

• Distributed cognition• Human-computer interaction analysis

paradigm

PDA• Knowledge resides

partly in theenvironment

Intellectual Partnership

Coordinating Coordinating internalinternal (user’s mind) (user’s mind) and and externalexternal (interface, environment) (interface, environment) resourcesresources

PDA

Dealing with Complexity and Surprises

RID Data Collection Data Collection

•Radio Identification (RID) TrackingRID technology is utilized to collect data only and not for active interventionTrack clinicians using RID badgesInfer clinician interaction based on audio recording and proximity

Simulation•Use RID data and ethnographic observation data to develop simulation•Use RID data to validate simulation

Data Collection Strategy

Integrated Audio-Visual Data Analysis Tool

Transfer of Technology: International Studies

• Africa: Electronic watches• Zimbabwe: Multimedia demonstration• India: Cell phonesLesson:Must not introduce technology in any

society without understanding the culture, cognition, and technology need

Thank You

Vimla.Patel@uth.tmc.edu

http://www.sahs.uth.tmc.edu/vpatel